The “bipolar spectrum” includes not only bipolar I disorder, but other conditions that involve depression or mood swings, too — with or without manic episodes.
The definition of bipolar disorder has changed over time. Some people still consider it a disorder that involves extreme mood changes only. But that isn’t entirely true — bipolar disorders are now understood to exist on a spectrum of mood-related symptoms.
While mood symptoms typically oppose each other, you don’t have to experience extreme mood changes to receive a diagnosis of bipolar disorder.
If you’re having trouble with mood shifts and think you may have a bipolar disorder spectrum disorder, various bipolar disorder treatments can help improve and stabilize your mood.
The defining characteristics of bipolar disorder are mood changes experienced as alternating episodes of mania, depression, or something in between.
Historically, people thought that if you had bipolar disorder, you experienced alternating episodes of mania and depression. However, as research into the condition evolved, experts realized that the symptoms are not always so clear-cut.
For example, people with bipolar disorder may experience episodes of depression followed by an episode of irritability and a mild increase in energy. Yet, another person may experience a depressive episode followed by a manic episode that results in hospitalization.
Both experiences fall onto the bipolar spectrum and are considered different types of bipolar disorder.
There are four main types of bipolar disorder grouped under the bipolar spectrum:
- bipolar I disorder
- bipolar 2 disorder
- bipolar disorder not otherwise specified
These types of bipolar disorder appear in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).
The symptoms can be distinct and include sharp alternations between manic and depressive states, or they can be less noticeable and include symptoms that are similar to manic and depressive episodes, but not as severe.
Bipolar I disorder
To be diagnosed with bipolar I disorder you must experience at least one manic episode. This is usually — but not always — followed by a depressive episode that lasts at least 2 weeks.
Mania is the major defining characteristic of bipolar I disorder. It is usually severe and debilitating enough that hospital care may be necessary, and the symptoms last for at least 7 days.
The symptoms of mania include:
- extreme happiness or euphoria
- very high self-esteem
- needing less sleep
- racing or uncontrollable thoughts
- being very talkative or pressured speech
- frequently changing ideas or topics while speaking
- feeling extremely irritable
- getting easily distracted
- feeling restless
- engaging in potentially harmful behavior
Bipolar II disorder
Bipolar II disorder is characterized by episodes of major depression that last at least 2 weeks. Following these episodes are typically periods of hypomania, which is a milder experience of mania that lasts around 4 days.
Hypomania symptoms are the same as mania symptoms but are less severe and aren’t present for as long. The symptoms interfere less with your life and do not require a hospital visit.
The symptoms of depression include:
- feeling sad, empty, or in despair
- loss of interest in activities you usually enjoy
- feelings of guilt or worthlessness
- difficulty concentrating
- changes in appetite
- changes in weight
- thoughts of suicide
Cyclothymia is similar to bipolar II disorder, but the symptoms are less severe. It consists of an alternation between emotional highs and lows that don’t meet the criteria for hypomanic or depressive episodes.
However, the symptoms are present most of the time for at least 2 years and are still severe enough to cause significant distress. The symptoms will usually interfere with your function in some way, but they don’t meet the criteria for bipolar I disorder or bipolar II disorder.
Bipolar disorder not otherwise specified
If you identify with some of the symptoms of mania and depression, but not fully, then you may receive a diagnosis of bipolar disorder not otherwise specified.
For example, you may experience depressive symptoms for less than 2 weeks, or manic symptoms for less than a week.
If you don’t entirely meet the criteria for bipolar I disorder, bipolar II disorder, or cyclothymia, it doesn’t mean that your symptoms aren’t real or distressing enough for treatment.
Lithium is a common mood stabilizer used to treat episodes of mania and depression. Researchers do not know exactly how or why it works, but they believe it can regulate mood-related chemicals in the brain.
In some cases, an antipsychotic such as valproate can accomplish the same goal.
Medical professionals often recommend medications to help stabilize your mood alongside psychotherapy. Psychotherapy aims to help you develop skills that allow you to better manage your symptoms.
Psychoeducation and cognitive behavioral therapy (CBT) are two common psychotherapies for bipolar disorder. Both approaches are supported by evidence and show benefits for people living with bipolar disorder.
Psychoeducation helps you understand more about why bipolar disorder treatment is important. If you sometimes feel that you don’t need treatment, psychoeducation can help you understand how it may be beneficial.
CBT helps you identify and change unhelpful thoughts, behaviors, and beliefs. It can include psychoeducation but mainly aims to help you develop realistic strategies that lessen the burden of living with bipolar disorder.
The bipolar spectrum includes four disorders with distinct symptom profiles. This means your experience of bipolar disorder may not be the same as another person’s experience.
If you feel your mood alternates between high and low states, help is available. You can check out some of these helpful resources to take the first step toward feeling better: